The use of a mobile spirometry with a feedback quality assessment in primary care setting - A nationwide cross-sectional feasibility study

Piotr Jankowski; Katarzyna Górska; Katarzyna Mycroft; Piotr Korczyński; Mateusz Soliński; Łukasz Kołtowski; Rafał Krenke

doi:10.1016/j.rmed.2021.106472

The use of a mobile spirometry with a feedback quality assessment in primary care setting - A nationwide cross-sectional feasibility study

Respir Med. 2021 Aug:184:106472. doi: 10.1016/j.rmed.2021.106472. Epub 2021 May 18.

Authors

Piotr Jankowski¹, Katarzyna Górska², Katarzyna Mycroft¹, Piotr Korczyński¹, Mateusz Soliński³, Łukasz Kołtowski⁴, Rafał Krenke¹

Affiliations

¹ Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland.
² Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland. Electronic address: katarzyna.gorska@wum.edu.pl.
³ Faculty of Physics, Warsaw University of Technology, Warsaw, Poland.
⁴ 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

PMID: 34049155
DOI: 10.1016/j.rmed.2021.106472

Abstract

Objectives: Mobile phone-linked portable spirometers are light-weight, easy to use and low cost, with new software to facilitate data collection. In this study we investigated the feasibility of the AioCare® mobile spirometry in primary care.

Methods: In this nationwide, cross-sectional study, AioCare® spirometers (HealthUp, Poland) were distributed among primary healthcare centres across Poland. Operators (primary care professionals) received a 2-h training session, after which spirometry was performed in patients attending routine visits with respiratory symptoms or risk factors for obstructive airway diseases. Spirometry was considered technically correct when at least three manoeuvres met ERS/ATS acceptability and repeatability criteria. The most common spirometry errors were assessed and stepwise logistic regression was applied to identify factors associated with technically correct spirometry. Airway obstruction was defined as FEV₁/FVC below the lower limit of normal. A restrictive pattern was defined as FVC below the lower limit of normal.

Results: Between 1 September 2018 and 1 September 2019, 10,936 spirometry examinations were performed in 9855 patients by 673 operators. 5347 (49%) spirometry examinations met both acceptability and repeatability criteria. The most common error was plateau error (17.7%). Operator age >40 years (OR 1.49, 95% CI 1.35-1.64) and repetition of the examination at the same visit (OR 1.90, 95% CI 1.66-2.16) increased the likelihood of a technically correct examination. Airway obstruction was found in 17% of correctly performed spirometry examinations.

Conclusions: Our nationwide study suggests that use of the AioCare® mobile spirometer in primary care could be feasible. More intensive and continual training should be implemented to improve the quality of spirometry examinations.

Keywords: Airway obstruction; COPD; National scale; Portable spirometer; Primary care; Spirometry.

MeSH terms

Adult
Cell Phone*
Cross-Sectional Studies
Data Collection
Feasibility Studies
Female
Humans
Logistic Models
Male
Middle Aged
Mobile Applications*
Poland
Primary Health Care / methods*
Quality Assurance, Health Care / methods*
Reproducibility of Results
Respiratory Tract Diseases / diagnosis*
Respiratory Tract Diseases / physiopathology*
Software
Spirometry / methods*